Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China.
Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.
Infect Dis Poverty. 2023 Mar 16;12(1):19. doi: 10.1186/s40249-023-01068-1.
The levels of resource losses due to coronavirus disease 2019 (COVID-19) and mental distress may change during the pandemic period. Based on the Conservation of Resource (COR) Theory, this study investigated such changes and the mediation between survey time (Round 2 versus Round 1) and depression via resource losses.
Two serial random population-based telephone surveys interviewed 209 and 458 Hong Kong Chinese adults in April 2020 and May 2021, respectively. Probable depression was defined as 9-item Patient Health Questionnaire (PHQ-9) score ≥ 10. The validated Conservation of Resources Scale for COVID-19 (CORS-COVID-19) scale was used to assess resource losses due to COVID-19. Multivariable logistic regression analysis, hierarchical logistic regression analysis, and structural equation modeling (SEM) was conducted to test the association, interaction, and mediation hypotheses, respectively.
The prevalence of probable depression declined from 8.6% to 1.0% over time, together with reductions in losses of financial resource (Cohen's d = 0.88), future control (Cohen's d = 0.39), social resource (Cohen's d = 0.60), and family resource (Cohen's d = 0.36) due to COVID-19. All the overall scale/subscales of the CORS-COVID-19 were positively and associated with probable depression [adjusted odds ratio (aOR) ranged from 2.72 to 42.30]. In SEM, the survey time was negatively associated with the latent variable of resource loss (β = - 0.46), which in turn was positively associated with probable depression (β = 0.73). In addition, the direct effect of survey time on probable depression was statistically non-significant (β = - 0.08), indicating a full mediation effect of resource losses.
The lessening of the resource losses might have fully accounted for the significant decline in probable depression from Month 3 to 15 since the first COVID-19 outbreak in Hong Kong, China. The level of depression might have increased during the first phase of the pandemic, but might decline in the later phases if resources losses could be lessened. All stakeholders should hence work together to minimize individuals' COVID-19-related resource losses to prevent depression in the general population, as COVID-19 might be lasting.
由于 2019 年冠状病毒病（COVID-19）和精神困扰，资源损失的水平可能会在大流行期间发生变化。基于资源保存（COR）理论，本研究通过资源损失调查了这种变化以及调查时间（第二轮与第一轮）与抑郁之间的中介作用。
2020 年 4 月和 2021 年 5 月，两次连续的随机人群基础电话调查分别采访了 209 名和 458 名香港中国成年人。可能的抑郁症定义为 9 项患者健康问卷（PHQ-9）得分≥10。使用经过验证的 COVID-19 资源保存量表（CORS-COVID-19）量表评估因 COVID-19 而导致的资源损失。进行多变量逻辑回归分析、层次逻辑回归分析和结构方程模型（SEM）分析，分别测试关联、交互和中介假设。
随着时间的推移，可能的抑郁症患病率从 8.6%下降到 1.0%，同时由于 COVID-19，财务资源（Cohen's d=0.88）、未来控制（Cohen's d=0.39）、社会资源（Cohen's d=0.60）和家庭资源（Cohen's d=0.36）的损失也有所减少。CORS-COVID-19 的所有整体量表/子量表均与可能的抑郁症呈正相关[调整后的优势比（aOR）范围为 2.72 至 42.30]。在 SEM 中，调查时间与资源损失的潜在变量呈负相关（β=-0.46），而资源损失的潜在变量又与可能的抑郁症呈正相关（β=0.73）。此外，调查时间对可能的抑郁症的直接影响具有统计学意义（β=-0.08），表明资源损失具有完全的中介效应。
自中国香港首次爆发 COVID-19 以来的第 3 至 15 个月，资源损失的减少可能完全解释了可能的抑郁症显著下降。在大流行的第一阶段，抑郁水平可能会升高，但如果资源损失能够减少，在后期阶段可能会下降。因此，所有利益相关者都应该共同努力，最大限度地减少个人与 COVID-19 相关的资源损失，以防止大流行期间一般人群的抑郁，因为 COVID-19 可能会持续存在。
